Here to hear Capt Michael Weiner talk about the Defense Health Information Management System (DHIMS) and the lessons that the DOD have learned.  I have a personal interest as I grew-up in the military health system and my parents and a large number of family members are in it now.  I haven’t been posting a lot of notes as I’ve just been absorbing, but this session should has lots of good information.

• This isn’t a technical issue.  It is a “cultural, paradigm, shift”.
• Don’t  be HIPAA compliant for the sake of compliance.  Be compliant because it will protect your patient’s information.
• Challenges to be faced when implementing:
  • Development of functional requirements
  • Maintainability/Interoperability
  • Acquisition Process
  • Enterprise Architecture
  • Theater Communications and Bandwidth
• Steady and reliable network is critical
• Buy-in from the team, physicians and support staff, is critical
• EHR will not fix a broken process. Take time to document the workflow and understand How You Do It. Used a great analogy for that by talking about Starbucks’s great workflow and a hotel coffee shop’s poor workflow. (I had a similar bad experience at a coffee shop at the airport. Had to find the spot with the lids and crossed paths twice.)
• Try it out first.  Pilot it and include it everyone in the office from day one.
• New and Shiny May Not Be Best.  Test the ergonomics of the hardware.  Different participants may need different hardware options.  A tablet has to be carried, so they put a computer on wheels that let them move other things as well.
• System needs to be intuitive.  IT guys aren’t always around.  The system needs to make it easy for the physicians that may not be technical.  Needs visual feedback mechanisms.
• See One, Do One, Teach One: hybrid education efforts.  Classrooms, 1-on-1, over-the-shoulder, and computer-based resources for training.
• Use the Web: Look at web hosting and virtualized solutions, especially for smaller clinical offices. (Talk of using the cloud without the term “Cloud”. Awesome.)
• Wireless networking and no mice.  Wires are bad and cause problems.
• Use multiple methods to input clinical healthcare data.  Use templates, auto fillers, macros, scribe, speech recognition (not everyone can type), dropdown menus.  It should support Workflow.
• Change is not always accepted, so empowering staff to get their “buy in” will help with adoption.  The team has to be involved, though that doesn’t diminish the need for a champion.
• Make it Personal: Patient centric care and patient portals is a shift for the patient community.  It will be a generation+ transition for the patients.
• Sharing is Caring. The Nationwide Health Information Network (NHIN) is the “dial-tone” for the future.  Every EHR is going to have to fit in.

Captain Weiner was a great presenter.  Loved the presentation.  Lot’s of good lessons that apply to large and small facilities.  Now off to catch-up with my colleagues.

Disclaimer

All information in this post was gathered from the presenters and presentation. It does not reflect my opinion unless clearly indicated (Italics in parenthesis). Any errors are most likely from my misunderstanding a statement or imperfectly recording the information. Updates to correct information are reflected in red, but will not be otherwise indicated.

So I missed the keynote due to a conference call that was not to be missed.  I also realized that coffee is going to be a battle in lines.  Luckily I had heard those rumors and planned ahead and brought chocolate covered espresso beans.

To kick things off, I’m going to listen to the Governor of Vermont, Jim Douglas.  He is going to be talking about how HIE (Health Information Exchange) is important for the States in their interactions with the Federal Government.  Let’s see what I can learn.

• (This is a little more like a speech, with a healthy political bent, than I would have liked. Will likely lead to less notes.)
• Wants to turn patients into consumers of their own health information.
• Vermont uses health teams centered around the Primary Care Physician (PCP) to break down silos of information at different locations.
• (A lot of examples of WHY to go electronic and have interoperable information.  Vermont seems to be making some solid strides in that direction, but I suspect that many here already are sold.)
• Federal and State officials, providers, insurers, vendors, and patients need to all work together to make HIE work.
• What will work in one state may not work everywhere.  Same applies to physicians.  Need to maintain flexibility on the details.
• Long-term funding for information exchanges is important after the recovery money runs out.
• Health IT is not the end, but the means to the end. (Obvious, but important to reinforce)
• Vermont has a 0.2% assessment on insurance claims to assist with sustainable funding for HIE.
• State lines cannot demarcate HIE as hospital systems and patients don’t stay in one state. (Where I live in DC metro, we have Virginia, Maryland, and DC, so this is an important point.)

Enough of the Q&A as I need sustenance.  Heading to a pair of Federal Health Community Synergy Sessions next.

Disclaimer

All information in this post was gathered from the presenters and presentation. It does not reflect my opinion unless clearly indicated (Italics in parenthesis). Any errors are most likely from my misunderstanding a statement or imperfectly recording the information. Updates to correct information are reflected in red, but will not be otherwise indicated.

This is going to be a busy week for me.  I am off to HIMSS 2010 in Atlanta for a two primary reasons (and about a thousand secondary).  The first is to support my Healthcare colleagues from Washington Consulting at the conference.  The second, which will make the first all the more challenging, is to learn more about the vertical that is Healthcare IT.

Before I jump into it, a funny little joke.  When I was in a meeting and we were talking about the trip to HIMSS, someone mentioned HL7. Being one of many new terms to me, I didn’t ask them what it meant, just glanced at them with a curious look on my face.  They told me, and I kid you not, Look it up later. Just remember that there is no HL6 or 8.  Thanks for the help guys. ( I did learn what it was later and actually understood the “7″ reference.)

Haven’t I Heard This Before?

So as I did research to get ready to hit the ground running, I saw a lot of challenges that the Healthcare industry is facing on the IT side.  I had heard most of it from a high level before in news reports and in Information Management/ECM case studies.  I had also picked some information up in planning for this year’s AIIM CMIS Demo.

When you strip out the names of the federal mandates and the acronyms that are common in the industry, I saw a lot words that I understood quite well:

• Interoperability: The Interoperability Showcase is a big piece of HIMSS.  I understand this problem from Content Management.  In fact, as you may have noticed, this is one of my favorite topics to discuss.  Between AIIM’s iECM Committee and all my efforts with CMIS, I think I understand the core needs well.
• Standards: Very related to interoperability, but separate.  There are several standards out there for Electronic Health Records (EHR) and Electronic Medical Records (EMR), not to mention other standards in the Healthcare space.  How do you evaluate those standards for usability, adoption, and sustainability?  Once again, not that much different from the evaluations of CMIS and the ECM standards before that.
• Legacy Paper Records: Wait a second, this I know. You have all these patient records in paper format.  You need them in your EMR and EHR systems.  New records may be electronic, but a patient’s medical history from pre-electronic days needs to be part of the integrated whole.  Scanning of those records, capturing key data elements, and making them available is the same thing we’ve been doing for years just about everywhere.
• Records Management: How long do you keep a patient record?  How do you manage it?  What about records about maintaining hospital equipment?  This is the same problems that federal agencies and companies dealing with SOX compliance have been solving, or attempting to solve, for years.
• Privacy: This is very important.  You don’t want a patient’s health information being compromised.  That is the most personal of your information.  Information needs to be secure, yet shared, all at the same time.  Once again, this is not a new problem.  In the federal government, information about citizens are stored and used all the time.  Personally Identifiable Information (PII) is a source of a lot of auditing and control in many systems.  Even the exact queries that people use to retrieve information needs to be tracked and reported upon.

You know something? Maybe I know a little something about Healthcare IT after all.

Wandering, Learning, and Posting

So I am going to be attending sessions and talking to people for five days down in Atlanta.  I am hoping to define the size of the gap in my domain knowledge, and work towards filling that gap.  I am also going to post notes from some sessions in a similar fashion to my EMC World posts.  I will throw in the following disclaimer:

All information in this post was gathered from the presenters and presentation. It does not reflect my opinion unless clearly indicated (Italics in parenthesis). Any errors are most likely from my misunderstanding a statement or imperfectly recording the information. Updates to correct information are reflected in red, but will not be otherwise indicated.

If you find anything of interest in these posts, and are at HIMSS, feel free to reach me on Twitter (@piewords).  I’m looking for people to talk to that will expand my knowledge and deepen my understanding of the Healthcare industry.

Like all industries, there are unique challenges and environments in Healthcare IT.  Like all industries, when you look at the core of the Information Management problem, you see similarities across the board, and lessons that can be brought to bear to solve them.

Going to be quite a ride this week. Stay tuned to see how I fare.